Covid-19 is a global disaster, but there is light in the darkness for FICEBO!

How did a prolific Aussie researcher end up joining the FICEBO team?

This is a question I have had to respond to a number of times. If this was purely a scientific article, we would have to ask her but here is my (Teppo Järvinen) take.

I first met Dr. Clare Ardern at the 3rd annual meeting of the Finnish Sports Physiotherapists Association (FSPA), in Helsinki, 2017. Introduced by mutual friends, Professors Ewa Roos and Karim Khan, Clare and I talked for hours about our shared passion for improving the quality of information available to clinicians when they make decisions in practice.

We kicked off by diving into treatments for shoulder pain—what treatments do clinicians usually offer to patients? Why? Do these treatments work? Eventually FICEBO (led by Dr. Teemu Karjalainen, Dr. Jarkko Jokihaara and Dr. Tuomas Lähdeoja) teamed up with two prestigious global research agencies, the Cochrane Collaboration and BMJ Rapid Recommendation to try to find answers to these important questions. The work culminated in 4 important research publications, including a BMJ Rapid Recommendation clinical practice guideline that has helped clinicians move from a surgery-first mindset to recommending non-invasive treatments like exercise.

My FICEBO colleagues badgered me to formally recruit Clare into the FICEBO ‘family’. My response: “Why would Clare come to Finland and join FICEBO? She is out of our league!” March 2020 rolled around, bringing a merry-go-round of cancelled conferences, stay-at-home orders, physical distancing and remote working. Suddenly, recruiting an international researcher to FICEBO didn’t seem so farfetched. Happily, Clare, who is based in Stockholm at the renowned Karolinska Institute, was delighted to accept an offer to join FICEBO! Within the week, FICEBO had its inaugural visiting professor.

Boy, it is fun to work with a talented researcher who has fantastic skills in research methodology, editorial expertise and scientific writing in her arsenal. Clare’s first published contribution as a fully-fledged FICEBO member was to a scientific commentary on what might explain declining rates of arthroscopic surgery around the world. De-implementing (stopping clinicians performing unnecessary surgeries) arthroscopy is at the heart of FICEBO activities, now over a decade old, thanks to our placebo-surgery controlled FIDELITY, FIMPACT and FIRST trials.

FICEBO members have contributed to international discussions about how to stop unnecessary surgeries. I have given a number of talks on this topic, most recently at the premier world conference on low value care, the Preventing Overdiagnosis in Sydney, Australia, in December 2019. But our views were still a bit rough around the edges and needed some outside-the-box thinking to nail down the message—here, Clare’s scientific communication skills shine.

In Finland, we believe we are witnessing a ‘grass-roots’, clinician-led reversal of arthroscopy as first-line clinical practice. FICEBO members and many of our orthopaedic surgeon colleagues cannot understand why specialty societies continue to endorse arthroscopy despite overwhelming evidence of its futility. Friend of FICEBO, Malcolm Willett (legendary cartoonist who is famous in the medical world for his work in the BMJ), asked whether his latest cartoon captured the essence of clinician-led reversal. We’ll let you, dear reader, be the judge.

Unfortunately, Covid-19 prevented us from meeting in person in 2020, but we continue to collaborate on a number of different projects with Clare. Keep an eye on this wonderful person, as we are confident that Clare will go to ‘places’ before long. But until that time, we are most grateful to have had a chance to collaborate with her! Welcome to our team, Clare!